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Flexible Spending Accounts

A Flexible Spending Account (FSA) helps you pay for health care or dependent care costs using tax-free dollars. Your
contribution is deducted from your paycheck on a pretax basis and is put into the FSA. When you incur expenses, you can
access the funds in your account to pay for eligible expenses. This chart shows the eligible expenses for each FSA and
how much you can contribute each year. Each of these options reduces your taxable income.

Account type Eligible expenses Annual contribution limits
Most medical, dental and vision care expenses Maximum contribution is $2,850 per year.
Health Care FSA that are not covered by your health plan (such as Funds are deducted throughout the year,
copayments, coinsurance, deductibles, eyeglasses but all funds are available on January 1.
and prescriptions)
Dependent care expenses (such as day care, Maximum contribution is $5,000 per year
after school programs or eldercare programs) ($2,500 if married and filing separate
Dependent Care FSA for children under age 13 or eldercare so you and tax returns).
your spouse can work or attend school full-time Funds are available for use as soon as your
contributions are deposited into your account
throughout the year.

Important information about FSAs
Your FSA elections are effective from January 1 through December 31. Claims for reimbursement must be
submitted by March 31 of the following year. Our Health Care FSA allows you to carry over $570 in unused
funds to the following plan year.

Please plan your contributions carefully. Any unused money remaining in your account(s) will be forfeited.
This is known as the “use it or lose it” rule and it is governed by Internal Revenue Service regulations. Note that
FSA elections do not automatically continue from year to year; you must actively enroll each year.

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